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Patterns of complex emergency general surgery in Canada.

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Summary

Emergency general surgery (EGS) in Canada involves complex conditions beyond appendicitis and gallstones. This study highlights the significant operative burden and associated risks of morbidity and mortality in these nonbiliary, nonappendiceal EGS cases.

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Area of Science:

  • Surgery
  • Epidemiology
  • Health Services Research

Background:

  • Emergency general surgery (EGS) literature often focuses on appendiceal and biliary conditions.
  • EGS surgeons manage a wide spectrum of complex nonbiliary, nonappendiceal diseases.
  • Understanding the operative burden of these diverse conditions in Canada is crucial.

Purpose of the Study:

  • To describe the operative burden of nonbiliary, nonappendiceal emergency general surgery conditions across Canada.
  • To identify the epidemiology and patient outcomes for these EGS cases.
  • To inform future research and quality improvement initiatives in Canadian EGS.

Main Methods:

  • Multicentre retrospective cohort study of EGS patients in Canada (2014).
  • Included adult patients undergoing nonelective operative interventions for nonbiliary, nonappendiceal diseases.
  • Logistic regression analyzed predictors of morbidity and mortality.

Main Results:

  • 2595 patients included; median age 60 years.
  • Common diagnoses: small bowel obstruction (16%), hernia (15%), malignancy (11%).
  • High complication rate (33%) and in-hospital mortality (8%), associated with older age, higher ASA score, and inter-centre transfer.

Conclusions:

  • Characterizes the epidemiology of nonbiliary, nonappendiceal EGS operative interventions in Canada.
  • Canadian EGS services handle a large volume of complex cases with substantial morbidity and mortality risks.
  • Findings will guide future research and quality improvement benchmarks for EGS.